Form 7 – Medical Authorization Workers' Comp Forms Fri, 05/24/2019 - 12:00 Read more about Form 7 – Medical Authorization
Form 6 – Notice and Application for Hearing – rev 9-11 Workers' Comp Forms Fri, 05/24/2019 - 12:00 Read more about Form 6 – Notice and Application for Hearing – rev 9-11
Form 5 – Employee’s Notice of Injury and Claim for Compensation – Rev 9-11 Workers' Comp Forms Fri, 05/24/2019 - 12:00 Read more about Form 5 – Employee’s Notice of Injury and Claim for Compensation – Rev 9-11
Form 4 – Report of Fatal Accident – Last Revised 9-11 Workers' Comp Forms Fri, 05/24/2019 - 12:00 Read more about Form 4 – Report of Fatal Accident – Last Revised 9-11
Form 2 – Denial of Workers’ Compensation Benefits – Rev 4-2018 Workers' Comp Forms Fri, 05/24/2019 - 12:00 Read more about Form 2 – Denial of Workers’ Compensation Benefits – Rev 4-2018
First-Aid Only Injuries and Deductible Policies Workers' Comp Forms Fri, 05/24/2019 - 12:00 Read more about First-Aid Only Injuries and Deductible Policies
Form 1 – Employee’s Claim & Employer’s First Report of Injury – Rev 9/11 Workers' Comp Forms Fri, 05/24/2019 - 12:00 Download and submit this form by email to Labor.WCfirstreport@vermont.gov or fax to 802-828-2195. Read more about Form 1 – Employee’s Claim & Employer’s First Report of Injury – Rev 9/11
Payment Scheduling Clarification Guidance Document Workers' Comp Forms Fri, 05/24/2019 - 12:00 Read more about Payment Scheduling Clarification Guidance Document
